Emergency airway management with fiberoptic intubation in the prone position with a fixed flexed neck.
We describe emergency airway management with fiberoptic intubation in a patient in the prone position with her neck flexed by a head pin holder during a neurosurgical procedure. Laryngeal mask airway is suggested in emergency difficult airway algorithms; however, this was not feasible in this patient because of her edematous upper airway and limited mouth opening resulting from extreme neck flexion by a head pin holder. The case illustrates the role of fiberoptic intubation in emergency airway management in this critical situation. Maneuvers to facilitate fiberoptic technique are also described.
Hung
Ming-Hui
MH
Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, 7, Chung-San South Road, Taipei, Taiwan.
Fan
Shou-Zen
SZ
Lin
Chun-Po
CP
Hsu
Yen-Chun
YC
Shih
Po-Yuan
PY
Lee
Tzong-Shiun
TS
D000402:Airway Obstruction / Q000209:etiology* / Q000628:therapy*; D004630:Emergencies; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D017214:Laryngeal Masks / Q000009:adverse effects; D007830:Larynx; D009333:Neck; D011187:Posture; D016684:Prone Position; D012121:Respiration, Artificial / Q000009:adverse effects; D014140:Tracheotomy / Q000009:adverse effects